Provider Demographics
NPI:1508887662
Name:BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Entity Type:Organization
Organization Name:BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ONUSCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-789-5899
Mailing Address - Street 1:25155 RYE CANYON LOOP
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5004
Mailing Address - Country:US
Mailing Address - Phone:866-789-5899
Mailing Address - Fax:877-835-2520
Practice Address - Street 1:25155 RYE CANYON LOOP
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5004
Practice Address - Country:US
Practice Address - Phone:661-949-4000
Practice Address - Fax:877-835-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX IDENTIFICATION NUMBER
CAY998Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA=========OtherTAX IDENTIFICATION NUMBER
CAAP340AMedicare PIN